Philippine E-Journals

Perianal Infection As a First Sign of Acute Myeloid Leukemia

Gabriel Mark P. Mercado | Ma. Rosario E. Bonagua

Discipline: medicine (non-specific)

 

Abstract:

Acute Myeloid Leukemia (AML) is the most common acute leukemia in older patients. Long-term survival is infrequent. Symptoms include fever, infection and hemorrhage. AML is treated with chemotherapy. The initial goal is to induce Complete Remission (CR). Once CR is obtained, further therapy must be given to prolong survival and achieve cure. Demise is more frequent with advancing age and medical comorbidity. This is a case of a 54-year-old male presenting with perianal infection. Physical findings revealed perianal abscess on the right inner gluteal area, lymphadenopathies, edema and tenderness on the leg. Diagnostic tests revealed hypokalemia, anemia, hyperleukocytosis and thrombocytopenia prompting admission. Patient was referred to Hematology, Surgery and Infectious Disease services. Flow cytometry revealed blast population of myeloid lineage which was most compatible with AML. He underwent Fluorescence-In-Situ-Hybridization (FISH) for prognostication. Transfusion of platelet concentrate and packed RBC was done. He underwent local incision and drainage of perianal abscess. Patient was discharged and achieved CR after one month, He was readmitted due to recurrence of anal pain and subsequently expired due to hemorrhagic complications. It is recommended that prompt consult should be done once manifestation of AML is noted so that early diagnosis and proper management can be given.